New here & eye screen results

[chelle2183]

Hi

Im new here so bear with me, Im a type 1 diabetic diagnosed at 17 im 29 now.

Im 22 weeks pregnant with my 2nd and have a question about eye screening results.

I had one done at 7 weeks pregnant which showed no changes to my eyes and this has always been the case for me until now

I received a letter following my 2nd trimester eye screen last week that says I have some early diabetic changes to my eyes im only 29 so very worried despite the letter saying no immediate cause for concern!

I am trying to set up an appointment with a member of my diabetes team to discuss this but hoping someone can advise me tonight. Has this happened to anyone else? What does it mean for me? Is it inevitable that this will get worse? Is there any hope of reversing it?

 

[Northerner]

Hi Chelle, welcome to the forum, and congratulations on your pregnancy! 🙂

These 'early changes' are very common, also called 'background retinopathy, and can reverse themselves if you look after yourself, your BG levels and your blood pressure, so try not to worry 🙂

 

[chelle2183]

Thanks, I am trying very hard my antenatal clinic monitors me closely and test my hba1c every 4 weeks my latest result was 5.7% (or 39 in new terms) but prior to pregnancy it was horrible not a good excuse but had a few family emergency's the previous year and thoughts of looking after myself went out the window.

As my control is much tighter im finding im often on the low side for BG levels with the occasional high which sometimes seem to occur for no reason at all eg I tested prior to driving one day at 6 but within an hour was 11 despite it being over 2 hours since my last meal and having eaten nothing in that hour!!

I try not to have too many sweet treats but when I done the carb counting appointments they did not discourage rice pasta bread etc just taking the correct insulin to cover it, so if levels are good is it ok to continue eating them?

Honestly I just dont know what to do re diet as was not advised to change it (other than to eat fruit and veg general healthy eating)

 

[Northerner]

Thanks, I am trying very hard my antenatal clinic monitors me closely and test my hba1c every 4 weeks my latest result was 5.7% (or 39 in new terms) but prior to pregnancy it was horrible not a good excuse but had a few family emergency's the previous year and thoughts of looking after myself went out the window.

As my control is much tighter im finding im often on the low side for BG levels with the occasional high which sometimes seem to occur for no reason at all eg I tested prior to driving one day at 6 but within an hour was 11 despite it being over 2 hours since my last meal and having eaten nothing in that hour!!

I try not to have too many sweet treats but when I done the carb counting appointments they did not discourage rice pasta bread etc just taking the correct insulin to cover it, so if levels are good is it ok to continue eating them?

Honestly I just dont know what to do re diet as was not advised to change it (other than to eat fruit and veg general healthy eating)

I think that, whilst it is true in theory that you can eat what you want on insulin, it becomes much easier to carb count accurately and achieve better levels if you do not eat particularly high-carb meals. Many people find that if they have a high carb meal they have to inject at a higher ratio (e.g. more insulin per 10g carbs) for it. High carb meals might also digest more slowly, so it's possible to miss the peak of your insulin and end up with high levels, so it's probably best to try and maintain moderate carb intake 🙂

 

[chelle2183]

I think that, whilst it is true in theory that you can eat what you want on insulin, it becomes much easier to carb count accurately and achieve better levels if you do not eat particularly high-carb meals. Many people find that if they have a high carb meal they have to inject at a higher ratio (e.g. more insulin per 10g carbs) for it. High carb meals might also digest more slowly, so it's possible to miss the peak of your insulin and end up with high levels, so it's probably best to try and maintain moderate carb intake 🙂

I will try to lower my carb intake though i do find it difficult to cut out bread and potatoes i was given the number for my diabetes specialist nurse that is currently working alongside my ob consultant so I will call her tommorow im just very anxious about my eyes in truth its the first diabetes complication ive run in to x

 

[Lizzzie]

I have a very vague memory of being told last pregnancy that paradoxically, retinopathy often shows itself when women's control has become much tighter during pregnancy. I can't remember if the dr was telling me a fact or a theory at this point, but there was definitely some reason why eyes appeared to get worse during those 9 months than other 9 month periods that wasn't directly linked to poor control.....? Anyone.....?

If I'm not making this up or confused (both likely) maybe a DSN or the diabetologist at antenatal checks could explain it?

 

[trophywench]

Yes, eyes often go a bit squiffy during preg, but then also resolve themselves after the birth. Plus (orinarily, without being preg) I've had background changes in my eyes since before they started photographing them, I think the mid 1990's, but not positive, however definitely pre 1998.

And guess what? in 2012 I still have background changes. So it isn't a death sentence. Please do discuss it with DSN. I'm sure she will say the same thing!

The other thing eye-protective is good BP, so they will be watching that even more closely for a diabetic than a non-D preg anyway.

And I think you actually automatically get a retinal scan every trimester so don't be worried if they want to do another one!

I think in preg you just have to go with the flow and do whatever your hormones dictate to you at that exact time. From 20 weeks, the 'jelly bean' grows into a 'huge melon' and more and more insulin resistance will kick in esp in the third trimester. So fight the spikes after meals and just correct with either food or insulin as your body NEEDS it. And if you are going hypo, reduce the insulin, up thr carbs.

It's only right at the very end, when typically you are taking comparatively massive amounts of both insulins for a relatively small amount of carbs and you very abruptly become mega hypo - that it's a danger signal.

 

[chelle2183]

Thanks for getting back to me all, trophywench i really hope it resolves after pregnancy or at the very least doesnt progress as my control was poor pre pregnancy its a very big wake up call that i need to care for myself as much as my sons

Ive had horrible thoughts of loosing my sight and not seeing my childs faces as they grow up. How often are you screened have you been screened since background changes were seen? And im assuming your control has been good since it hasnt progressed?

 

[trophywench]

Highest A1cs ever, in the low 8's. Quite often there or thereabouts, until I had my pump when everything improved greatly.

I just get the normal scans annually.

I'm 62 by the way and past it as far as preg's concerned, esp since I had a total hysterectomy years ago! And my second husband had a vasectomy well before I had that done and before we even knew each other, so I always say well we best still keep TTC - cos I'm sure Hello! would pay us a lot of money if I did catch !!!!

 

[chelle2183]

Thanks

I think the fact that im only 29 and this is already happening is one of the things worrying me the most

Im just hoping i can get my eyes back to normal as impossible as that probably is or that the changes are very minor and stay that way.

 

[Steff]

Chelle hi and a warm welcome to the forum

 

[Monkey]

Pretty much what everyone else has already said, really. I'm 30, and had background retinopathy spotted in my first pregnancy (I was 27). I was told it was most likely pregnancy related, and altho one eye got slightly worse during the time I was pregnant, the other improved slightly. Weird, but that's how it seems to be!

My consultant was also of the view that given I've had T1 for 20years, diagnosed at 9 and have been thro teenage years / university / pregnancy, he wasn't seeing anything out of the ordinary. Whether you agree with that or not is another debate, but it did reassure me to some extent.

 

[chelle2183]

So i spoke to a screening person and she said i have 1 microaneursym in my right eye thats tiny n 1 in my left eye plus a spot in my left that she said that the spot looks to be resolving and that this may happen with the other 2 as well. Hopefully it will resolve after delivery though no guarentees obv. I'll be screened again in feb.

I just really hope it does resolve, easy for them to say dont worry but i still will.